Advanced observation and telemetry heart system utilizing wearable ECG device and a Cloud platform

Short lived chest pain episodes of post PCI patients represent the most common clinical scenario treated in the Accidents and Emergency Room. Continuous ECG monitoring could substantially diminish such hospital admissions and related ambulance calls. Delivering community based, easy-To-handle, easy to wear, real time electrocardiography systems is still a quest, despite the existence of electronic electrocardiography systems for several decades. The PATRIOT system serves this challenge via a 12-channel, easy to wear, easy to carry, mobile linked, miniaturized automatic ECG device and a Cloud platform. The system may deliver high quality electrocardiograms of a patient to medical personnel either on the spot or remotely both in a synchronous or asynchronous mode, enhancing autonomy, mobility, quality of life and safety of recently treated coronary artery disease patients

A high-speed wireless network used for telemedicine

Nowadays, there is growing interest in using telemedicine to provide non-face-to-face healthcare for patients. The emergence and development of WLAN (Wireless Local Area Network) technology, which supports high-speed wireless communications within the existing Intranet that covers the healthcare system, makes it possible to provide routine body check-ups for patients who need long-term monitoring. In this thesis, we present the design of a wireless telemedicine system using WLAN technology. [Continues.

Effectiveness of a handheld remote ECG monitor

This present study deals with designing a real-time remote handheld ECG monitoring system and evaluating its potential usefulness in early detection of heart conduction problems. The raw ECG recordings were sent by the handheld monitor (client) to a remote server, which performed an on-line ECG analysis and sent the results back to the client. Real-time feedback provided to the client included display of ECG, results of ECG analysis and alarms (if required). The objective of this work was to determine its effectiveness in real-time identification of particular pattern preceding ventricular fibrillation. The remote server identified the occurrence of QRS complex and premature ventricular contractions and monitored ECG for ventricular tachycardia and variations in heart rate variability indices. The sensitivity and specificity of the QRS detection to ECG recordings from MIT-Arrhythmia database were 99.34% and 99.31%, respectively. Similarly these parameters of the premature ventricular contraction detection were 87.5% and 91.67%, respectively. The time between alarm and the onset of ventricular fibrillation was measured on ECG recordings where premature ventricular contractions were found to lead to ventricular fibrillation. The remote monitor was able to successfully identify the onset on ventricular fibrillation. Early detection could contribute to better response to an emergency intervention. HRV indices sensitive to the differences between normal and subjects with congestive heart failure were monitored in real-time. They were heart rate, statistical index RMSSD, total spectral power, high frequency power and the ratio of low frequency to high frequency power (LFP:HFP). The effectiveness of HRV indices was tested on an ECG recording of a sleep study subject, who experienced cardiac arrhythmia. Cyclic changes observed in total spectral power prior to onset of cardiac arrhythmia could be attributed to REM sleep cycles. No other conclusive change in HRV indices was observed. The monitor's usefulness in predicting long-term prognosis of post-MI subjects was tested on ECG recordings from two subjects made immediately after conclusion of cardiac arrhythmia and during a follow-up visit. Both showed higher RMSSD, total spectral power and LFP:HFP ratio. Personalizing the monitor for each patient further improves its accuracy in measurement of various parameters

FHIR Tools for Healthcare Interoperability

Electronic Health Records (EHR) is an essential element in human healthcare monitoring systems these days. As a large amount of data continues being archived and uploaded to healthcare repositories, virtually every second across the globe, vast amount of data mining tasks continue being modelled and modified to extract valuable decision support information. The Health Level 7 (HL7) consortium provides the framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice, management and delivery. With the large number of Internet of Things (IoT) health care kits becoming available it has become increasingly difficult to log the real-time patient monitoring information to healthcare repositories. As patients continue being monitored in real-time it has become essential that the trauma events information such as stroke or cardiac arrhythmia be uploaded to the EHR in real-time. Currently available monitoring devices can monitor and analyse an abnormal condition but may not be able to upload these events in real-time. The proposed research focused on developing real-time interoperability tools and services, which can enable wearable IoT devices to interact with the EHR in real-time and can provide real-time decision support. The Fast Healthcare Interoperability Resources (FHIR) specification was used to develop and encode trauma related information in terms of FHIR resources, conceptual and logical models using clinFHIR tools. A HAPIFHIR application was implemented on an IoT device which could upload real-time ECG, PPG and relevant trauma information on a test FHIR server. The HAPIFHIR application code could encapsulate ECG arrhythmia, vital signs and trauma events in a single observation and could upload it to the HAPIFHIR server. Several such observations could be linked to a patient context and could be observed in real time in EHR. The ECG, the PPG, vital signs and trauma events were encoded according to Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) specifications. The alerts and alarms mechanism could assist the emergency response teams at the hospitals to prepare for an emergency well in time. An analogue front-end biomedical device was used for data acquisition and signal processing and the IoT devices were networked over wireless network to upload the events and observations to the FHIR server in real time. The system focussed on ‘preventive care’ as the next generation personalized health-care monitoring devices continue becoming available

Collaboration through Patient Data Access and sharing in the cloud

(c) 2014 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other users, including reprinting/ republishing this material for advertising or promotional purposes, creating new collective works for resale or redistribution to servers or lists, or reuse of any copyrighted components of this work in other works.There have been many socio-political and technological developments in the area of Electronic Patient Records (EPR). The technological aspects include EPR implemented using Online Transaction Processing (OTP) using Internet and Internet based systems, more recently via Cloud- Based systems (CBS) exploiting Cloud Service Models (CSM). Additionally, there are many socio-political considerations comprising: (1) political moves, including UK Government policy, which aims to deliver for patients 27/7 online access to their patient record, (2) considerations around ethical issues and informed permission and acceptance by the public and non-governmental organizations (NGO), (3) technological considerations about identification of suitable CBS and data structures in distributed systems characterized by unstructured data and, finally (4) sharing and collaboration as means of increasing efficiency, security, privacy, etc. In all, the aim is to provide professionals in medical domain with advanced platforms to not only access but also most importantly to share and collaborate at a wide scale level (e.g. National level). Addressing these aspects of EPR requires collaboration between all stakeholders in EPR, this paper considers these and concludes that such collaboration is essential if EPR are ever to become a reality.Peer ReviewedPostprint (author's final draft

Machine Learning in Wearable Biomedical Systems

Wearable technology has added a whole new dimension in the healthcare system by real-time continuous monitoring of human body physiology. They are used in daily activities and fitness monitoring and have even penetrated in monitoring the health condition of patients suffering from chronic illnesses. There are a lot of research and development activities being pursued to develop more innovative and reliable wearable. This chapter will cover discussions on the design and implementation of wearable devices for different applications such as real-time detection of heart attack, abnormal heart sound, blood pressure monitoring, gait analysis for diabetic foot monitoring. This chapter will also cover how the signals acquired from these prototypes can be used for training machine learning (ML) algorithm to diagnose the condition of the person wearing the device. This chapter discusses the steps involved in (i) hardware design including sensors selection, characterization, signal acquisition, and communication to decision-making subsystem and (ii) the ML algorithm design including feature extraction, feature reduction, training, and testing. This chapter will use the case study of the design of smart insole for diabetic foot monitoring, wearable real-time heart attack detection, and smart-digital stethoscope system to show the steps involved in the development of wearable biomedical systems

Sistema microcontrolado para transmissão de sinais de ECG pela internet

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia Elétrica.Este trabalho aborda o projeto e desenvolvimento de um sistema de telemedicina para eletrocardiograma (ECG), composto por um módulo d

The Impact of Consumer Smart Device Platforms on Illness Uncertainty and Anxiety in Patients with Atrial Fibrillation

Atrial fibrillation (AFib) is a common cardiac arrhythmia associated with increased risk for comorbid health conditions. Advancements in consumer technology have enabled patients to monitor hearth rhythm independently, yet, much remains unknown about patient outcomes related to the use of these smart device platforms (SDP). The aim of this study was to examine the iatrogenic and/or remedial effects of SDP use on patient reported outcomes of illness uncertainty, cardiac anxiety, body vigilance, AFib symptoms, symptom burden, and healthcare utilization. The sample included 130 AFib participants (65 in SDP group) recruited through ResearchMatch, American Heart Association support forum, and other online AFib communities. Despite being of younger age, participants in the SDP group reported more medical risk factors associated with AFib. Results partially supported the iatrogenic effect, as participants with SDP reported greater cardiac anxiety and healthcare utilization relative to those without, even after accounting for covariates of age and medical risk factors. These findings should be interpreted with caution, as the global pandemic may have impacted the results obtained

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy

Smartphone-Based Endoscope System for Advanced Point-of-Care Diagnostics: Feasibility Study

Background: Endoscopic technique is often applied for the diagnosis of diseases affecting internal organs and image-guidance of surgical procedures. Although the endoscope has become an indispensable tool in the clinic, its utility has been limited to medical offices or operating rooms because of the large size of its ancillary devices. In addition, the basic design and imaging capability of the system have remained relatively unchanged for decades. Objective: The objective of this study was to develop a smartphone-based endoscope system capable of advanced endoscopic functionalities in a compact size and at an affordable cost and to demonstrate its feasibility of point-of-care through human subject imaging. Methods: We developed and designed to set up a smartphone-based endoscope system, incorporating a portable light source, relay-lens, custom adapter, and homebuilt Android app. We attached three different types of existing rigid or flexible endoscopic probes to our system and captured the endoscopic images using the homebuilt app. Both smartphone-based endoscope system and commercialized clinical endoscope system were utilized to compare the imaging quality and performance. Connecting the head-mounted display (HMD) wirelessly, the smartphone-based endoscope system could superimpose an endoscopic image to real-world view. Results: A total of 15 volunteers who were accepted into our study were captured using our smartphone-based endoscope system, as well as the commercialized clinical endoscope system. It was found that the imaging performance of our device had acceptable quality compared with that of the conventional endoscope system in the clinical setting. In addition, images captured from the HMD used in the smartphone-based endoscope system improved eye-hand coordination between the manipulating site and the smartphone screen, which in turn reduced spatial disorientation. Conclusions: The performance of our endoscope system was evaluated against a commercial system in routine otolaryngology examinations. We also demonstrated and evaluated the feasibility of conducting endoscopic procedures through a custom HMD